<div class=grid_18>
<div class=grid_10> 
    <div class=block-border> 
        <div class=block-header> 
            <h1>SDA Church - Kwabrafoso: Edit Baptism Records</h1><span></span> 
        </div> 

        <form id=validate-form class="block-content form" action="edit" method=post>
            
            <div class=_50> 
                <p><label for=stextarea>Baptismal ID</label> 
                    <input id="baptismid" name="baptismid" class="required" class="input-xlarge" type="text" value="<?php echo $record['Baptism']['baptismid'];?>"/>

                    <input type="hidden" id="record_id" name="record_id" value="<?php echo $record['Baptism']['baptismid'];?>"/> 
            </div>  
                
            <div class=_50> 
                <p><label for=textarea>Cadidate's Name</label>
                    <input id="caname" name="caname" class="" type="text" value="<?php echo $record['Baptism']['caname'];?>"/> 
            </div> 
            
            <div class=_50> 
                <p><label for=datepicker>Baptism Date</label>
                    <input type=date id="baptismdate" name="baptismdate" value="<?php echo $record['Baptism']['baptismdate'];?>"/>
            </div> 

            <div class=_50> 
                <p><label for=textarea>Union</label>
                    <input id="union" name="union" class"=required" type="text" value="<?php echo $record['Baptism']['union'];?>"/>
            </div>

            <div class=_50> 
                <p><label for=textarea>Conference</label>
                    <input id="conference" name="conference" class"=required" type="text" value="<?php echo $record['Baptism']['conference'];?>"/>
            </div> 
            
            <div class=_50> 
                <p><label for=textarea>Region</label>
                    <input id="region" name="region" class="required" type="text" value="<?php echo $record['Baptism']['region'];?>"/>
            </div> 
                
            <div class=_50> 
                <p><label for=textarea>District</label>
                    <input id="district" name="district" class=r"required" type="text" value="<?php echo $record['Baptism']['district'];?>"/>
            </div> 

            <div class=_50> 
                <p><label for=textarea>Town</label>
                    <input id="town" name="town" class=r" " type="text" value="<?php echo $record['Baptism']['town'];?>"/>
            </div>         

            <div class=_50> 
                <p><label for=textarea>Church</label>
                    <input id="church" name="church" class="required" type="text" value="<?php echo $record['Baptism']['church'];?>"/>
            </div> 

            <div class=_50> 
                    <p><label for=datepicker>Officiating Minister</label>
                     <input id"minister" name="minister" class="input-large"  type="text" value="<?php echo $record['Baptism']['minister'];?>"/>
            </div> 
            
            <div class=_50> 
                <p><label for=textarea>Certificate No</label>
                    <input id="baptismcert" name="baptismcert" type="text" class=" " value="<?php echo $record['Baptism']['baptismcert'];?>"/> 
            </div>

            <div class=block-actions> 
                <ul class=actions-left> 
                    <li><a class="button red" id=reset-validate-form href="javascript:void(0);">Reset</a></li> 
                </ul> 
                <ul class=actions-right> 
                    <li><input type=submit id="Save-Baptism List" class="button" value="Save Record"></li> 
                </ul> 
            </div> 
        </form> 
    </div> 
</div> 